Identification of risk factors associated with prolonged hospital stay following primary knee replacement surgery: a retrospective, longitudinal observational study.
| Title: | Identification of risk factors associated with prolonged hospital stay following primary knee replacement surgery: a retrospective, longitudinal observational study. |
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| Authors: | Wilson R; The National Institute for Health Research Applied Research Collaboration West (NIHR ARC West), University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK rebecca.wilson@bristol.ac.uk.; Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.; Margelyte R; Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.; Redaniel MT; The National Institute for Health Research Applied Research Collaboration West (NIHR ARC West), University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK.; Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.; Eyles E; The National Institute for Health Research Applied Research Collaboration West (NIHR ARC West), University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK.; Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.; Jones T; The National Institute for Health Research Applied Research Collaboration West (NIHR ARC West), University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK.; Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.; Penfold C; The National Institute for Health Research Applied Research Collaboration West (NIHR ARC West), University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK.; Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.; Blom A; Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.; Elliott A; North Bristol NHS Trust, Bristol, UK.; Harper A; The National Institute for Health Research Applied Research Collaboration South-West Peninsula (PenARC), University of Exeter, Exeter, UK.; Medical School, University of Exeter, Exeter, UK.; Keen T; North Bristol NHS Trust, Bristol, UK.; Pitt M; The National Institute for Health Research Applied Research Collaboration South-West Peninsula (PenARC), University of Exeter, Exeter, UK.; Medical School, University of Exeter, Exeter, UK.; Judge A; Translational Health Sciences, University of Bristol, Bristol, UK. |
| Source: | BMJ open [BMJ Open] 2022 Dec 16; Vol. 12 (12), pp. e068252. Date of Electronic Publication: 2022 Dec 16. |
| Publication Type: | Observational Study; Journal Article; Research Support, Non-U.S. Gov't |
| Language: | English |
| Journal Info: | Publisher: BMJ Publishing Group Ltd Country of Publication: England NLM ID: 101552874 Publication Model: Electronic Cited Medium: Internet ISSN: 2044-6055 (Electronic) Linking ISSN: 20446055 NLM ISO Abbreviation: BMJ Open Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: [London] : BMJ Publishing Group Ltd, 2011- |
| MeSH Terms: | Arthroplasty, Replacement, Knee*/adverse effects; Humans ; Female ; Aged ; Male ; Length of Stay ; Retrospective Studies ; Patient Discharge ; Risk Factors |
| Abstract: | Objectives: To identify risk factors associated with prolonged length of hospital stay and staying in hospital longer than medically necessary following primary knee replacement surgery.; Design: Retrospective, longitudinal observational study.; Setting: Elective knee replacement surgeries between 2016 and 2019 were identified using routinely collected data from an NHS Trust in England.; Participants: There were 2295 knee replacement patients with complete data included in analysis. The mean age was 68 (SD 11) and 60% were female.; Outcome Measures: We assessed a binary length of stay outcome (>7 days), a continuous length of stay outcome (≤30 days) and a binary measure of whether patients remained in hospital when they were medically fit for discharge.; Results: The mean length of stay was 5.0 days (SD 3.9), 15.4% of patients were in hospital for >7 days and 7.1% remained in hospital when they were medically fit for discharge. Longer length of stay was associated with older age (b=0.08, 95% CI 0.07 to 0.09), female sex (b=0.36, 95% CI 0.06 to 0.67), high deprivation (b=0.98, 95% CI 0.47 to 1.48) and more comorbidities (b=2.48, 95% CI 0.15 to 4.81). Remaining in hospital beyond being medically fit for discharge was associated with older age (OR=1.07, 95% CI 1.05 to 1.09), female sex (OR=1.71, 95% CI 1.19 to 2.47) and high deprivation (OR=2.27, 95% CI 1.27 to 4.06).; Conclusions: The regression models could be used to identify which patients are likely to occupy hospital beds for longer. This could be helpful in scheduling operations to aid hospital efficiency by planning these patients' operations for when the hospital is less busy.; (© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY. Published by BMJ.) |
| Competing Interests: | Competing interests: None declared. |
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| Contributed Indexing: | Keywords: adult orthopaedics; knee; orthopaedic & trauma surgery; rheumatology; statistics & research methods |
| Entry Date(s): | Date Created: 20221216 Date Completed: 20221220 Latest Revision: 20221222 |
| Update Code: | 20260130 |
| PubMed Central ID: | PMC9764602 |
| DOI: | 10.1136/bmjopen-2022-068252 |
| PMID: | 36526323 |
| Database: | MEDLINE |
Observational Study; Journal Article; Research Support, Non-U.S. Gov't